Individual
MRS. BROOKE M WISMONT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
54 MARRINER AVE, ALBANY, NY 12205-2936
(518) 512-3266
Mailing address
54 MARRINER AVE, ALBANY, NY 12205-2936
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
018200-1
NY
Other
Enumeration date
02/14/2011
Last updated
02/14/2011
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